1. Field of the Invention
This invention relates to a suture cutter, as well as a method of cutting a pair of suture tails using this suture cutter. More particularly, the present invention provides a suture cutter which may be employed to safely cut one or more suture tails which are positioned at a location which is not easily accessible to traditional suture cutting means.
2. Description of Related Art
The majority of surgical procedures rely upon various types of sutures for not only closing incisions, but also for connecting and/or supporting structures within the body. The use of sutures also usually requires the tying of one or more knots in order to secure the suture in place. After these knots are tied, the pair of suture tails extending from the knot normally must be cut. If the tails are cut too short or unevenly, the knot may become untied. Alternatively, if the tails are left too long, the suture tails may be irritating to the patient or become entangled with other structures.
The cutting of suture tails can often be accomplished merely by employing surgical scissors, particularly when the knot is located outside of the patient's body. Many times, however, the knot and accompanying suture tails are located within the patient's body, or within an orifice of the patient's body. For example, sutures may be tied within the abdomen of a patient during a surgical procedure. In these instances, it may be difficult for medical personnel to safely employ standard surgical scissors to cut the sutures after tying. Thus, various types of suture-cutting devices have been developed which enable the medical personnel to cut the sutures in a location which normally would not be accessible to a pair of conventional scissors. These devices of the prior art suffer from many drawbacks, however, including the risk of the cutting blade inadvertently injuring the patient or physician. In addition, vision is often impaired during these procedures, and thus it can be difficult for the medical personnel to insure that the suture tails are left at the proper length. Most of these devices are also unable to simultaneously cut both tails.
One particular surgical procedure where cutting suture tails can be problematic is laparoscopic urethropexy for treating stress urinary incontinence in women. This procedure is described in U.S. patent application Ser. No. 08/519,606, which is herein incorporated by reference. In this procedure, one or more bone anchors are laparoscopically secured to the pubic bone of the patient, preferably adjacent to the space of Retzius. A suture extends from each anchor, and is preferably looped through an aperture in the anchor such that a pair of suture tails extend from the anchor. The suture tails are then pulled into the vagina, preferably by a suture-retrieving device which passes through the vaginal mucosa and enters the abdominal cavity to grasp the suture tails. The suture tails are brought through the entire thickness of the periurethral fascia and vaginal mucosa such that each tail penetrates the tissue at a predetermined distance from the other tail, and from the urethra. These tails may then be tied to one another in order to elevate the urethra and thereby eliminate the incontinence.
Once the suture tails are tied to one another within the vagina, the tails must be cut. If the tails are cut too close to the knot or unevenly, the knot is likely to become untied, thereby eliminating the correction provided by the surgery. If the tails are left too long, on the other hand, the excess suture material will cause irritation to the patient and may not be fully epithelialized. Properly cutting the suture tails within the vagina can be difficult, however, due not only to the confined space, but also due to the lack of operative vision. Surgical scissors and the like may not only cut the tails at an improper or uneven length, but may also damage vaginal tissue during the process. It is also difficult to simultaneously cut more than one suture tail with conventional scissors.
The present invention offers a unique suture cutter designed to easily cut sutures located within a body cavity or orifice. This suture cutter is particularly suited for simultaneously cutting suture tails to their proper length during the above-described laparoscopic urethropexy procedure.